| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 Filed as: SEGAL GROUP | 333 WEST 34TH STREET NEW YORK, NY 100012402 | GARDEN STATE LIFE INSURANCE COMPANY | $53K | — | $53K | 5.00% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL INC | 75 REMITTANCE DR DEPT 1926 CHICAGO, IL 60675 | HARTFORD LIFE AND ACCIDENT | $749 | — | $749 | 0.29% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| KEYSTONE HEALTH PLAN EAST EIN 23-2314460 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $2.1M |
| JUDY O'MEARA EIN 23-2105239 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $145K |
| BASYS SYSTEMS EIN 52-1796473 NONE | Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $139K |
| DENISE KITZINGER EIN 23-2105239 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $132K |
| LINDA MCCULLOUGH EIN 23-2105239 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $129K |
| THE SEGAL COMPANY EIN 06-0839113 NONE | Other commissions; Actuarial; Direct payment from the plan Service code 11 | — | $125K |
| JOHN J RONGIONE EIN 23-2105239 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $123K |
| VERONICA MOORE EIN 23-2105239 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $113K |
| SONIA RODRIQUEZ EIN 23-2105239 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $107K |
| MADELYN VELEZ EIN 23-2105239 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $97K |
| BLUEWATER CONSULTING GROUP NONE | Consulting (general); Direct payment from the plan Service code 16 | 1100 E. HECTOR ST. SUITE 315 CONSHOHOCKEN, PA 19428 | $96K |
| SPEAR WILDERMAN P.C. EIN 23-2749511 NONE | Legal; Direct payment from the plan Service code 29 | — | $86K |
| TYEMA SANCHEZ EIN 23-2105239 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $82K |
| JOANNA OLEJNICZAK EIN 23-2105239 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $76K |
| DELTA DENTAL EIN 23-1667011 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $62K |
| LOCAL 36 BOLR PENSION PLAN EIN 23-6546776 RELATED FUND | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $59K |
| CYNTHIA LEAHY EIN 23-2105239 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $55K |
| DONNA HESTON EIN 23-2105239 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $54K |
| AMERIHEALTH PA HMO EIN 23-2314460 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $54K |
| STEVENS & LEE PC EIN 23-1886296 NONE | Legal; Direct payment from the plan Service code 29 | — | $51K |
| ERICA HARRELL EIN 23-2105239 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $47K |
| GARSON M. CARUSO, MD, MPH, PA. NONE | Direct payment from the plan; Consulting (general) Service code 16 | 647 E SIDDONSBURG RD MECHANICSBURG, PA 17055 | $43K |
| CARMEN MCCARTHY EIN 23-2105239 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $40K |
| NOVAK FRANCELLA LLC EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $25K |
| PFM ASSET MANAGEMENT, LLC. EIN 23-1992164 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $22K |
| CVS CAREMARK EIN 05-0494040 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $18K |
| NATIONAL VISION ADMINISTRATORS LLC EIN 74-3033381 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $18K |
| INDEPENDENCE BLUE CROSS EIN 23-2184623 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $15K |
| EXPRESS SCRIPTS EIN 43-1420563 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $7K |
| DE VALLEY HEALTH CARE COALITION EIN 23-2813763 NONE | Other commissions; Insurance agents and brokers; Other services Service code 22 | — | $7K |
| CROSS CURRENT CORPORATION EIN 23-2779645 NONE | Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $5K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 2,954 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,964 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE AND ACCIDENT | 3,229 | $257K |
| Stop-loss / reinsurancereinsurance | GARDEN STATE LIFE INSURANCE COMPANY | 3,092 | $1.1M |
| Other | HARTFORD LIFE AND ACCIDENT | 3,229 | $257K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,229 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.